{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T02:07:14Z","timestamp":1778033234150,"version":"3.51.4"},"reference-count":157,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The Gerstmann syndrome is a constellation of neurological deficits that include agraphia, acalculia, left\u2013right discrimination and finger agnosia. Despite a growing interest in this clinical phenomenon, there remains controversy regarding the specific neuroanatomic substrates involved. Advancements in data-driven, computational modelling provides an opportunity to create a unified cortical model with greater anatomic precision based on underlying structural and functional connectivity across complex cognitive domains. A literature search was conducted for healthy task-based functional MRI and PET studies for the four cognitive domains underlying Gerstmann\u2019s tetrad using the electronic databases PubMed, Medline, and BrainMap Sleuth (2.4). Coordinate-based, meta-analytic software was utilized to gather relevant regions of interest from included studies to create an activation likelihood estimation (ALE) map for each cognitive domain. Machine-learning was used to match activated regions of the ALE to the corresponding parcel from the cortical parcellation scheme previously published under the Human Connectome Project (HCP). Diffusion spectrum imaging-based tractography was performed to determine the structural connectivity between relevant parcels in each domain on 51 healthy subjects from the HCP database. Ultimately 102 functional MRI studies met our inclusion criteria. A frontoparietal network was found to be involved in the four cognitive domains: calculation, writing, finger gnosis, and left\u2013right orientation. There were three parcels in the left hemisphere, where the ALE of at least three cognitive domains were found to be overlapping, specifically the anterior intraparietal area, area 7 postcentral (7PC) and the medial intraparietal sulcus. These parcels surround the anteromedial portion of the intraparietal sulcus. Area 7PC was found to be involved in all four domains. These regions were extensively connected in the intraparietal sulcus, as well as with a number of surrounding large-scale brain networks involved in higher-order functions. We present a tractographic model of the four neural networks involved in the functions which are impaired in Gerstmann syndrome. We identified a \u2018Gerstmann Core\u2019 of extensively connected functional regions where at least three of the four networks overlap. These results provide clinically actionable and precise anatomic information which may help guide clinical translation in this region, such as during resective brain surgery in or near the intraparietal sulcus, and provides an empiric basis for future study.<\/jats:p>","DOI":"10.1093\/braincomms\/fcac140","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T19:56:29Z","timestamp":1654026989000},"source":"Crossref","is-referenced-by-count":16,"title":["A connectivity model of the anatomic substrates underlying Gerstmann syndrome"],"prefix":"10.1093","volume":"4","author":[{"given":"Qazi S.","family":"Shahab","sequence":"first","affiliation":[{"name":"School of Medicine, University of New South Wales , 2052 Sydney , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella M.","family":"Young","sequence":"additional","affiliation":[{"name":"Omniscient Neurotechnology , Sydney 2000 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8657-187X","authenticated-orcid":false,"given":"Nicholas B.","family":"Dadario","sequence":"additional","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ 08901 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onur","family":"Tanglay","sequence":"additional","affiliation":[{"name":"Omniscient Neurotechnology , Sydney 2000 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J.","family":"Nicholas","sequence":"additional","affiliation":[{"name":"Omniscient Neurotechnology , Sydney 2000 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueh-Hsin","family":"Lin","sequence":"additional","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital , Randwick 2031 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Dineth","family":"Fonseka","sequence":"additional","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital , Randwick 2031 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7336-5738","authenticated-orcid":false,"given":"Jacky T.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital , Randwick 2031 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Y.","family":"Bai","sequence":"additional","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital , Randwick 2031 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Teo","sequence":"additional","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital , Randwick 2031 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephane","family":"Doyen","sequence":"additional","affiliation":[{"name":"Omniscient Neurotechnology , Sydney 2000 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5407-2585","authenticated-orcid":false,"given":"Michael E.","family":"Sughrue","sequence":"additional","affiliation":[{"name":"Omniscient Neurotechnology , Sydney 2000 , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"2022061307105548100_fcac140-B1","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1136\/jnnp.72.3.403","article-title":"The Gerstmann syndrome in Alzheimer's disease","volume":"72","author":"Wingard","year":"2002","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2022061307105548100_fcac140-B2","first-page":"1010","article-title":"Fingeragnosie-eine umschriebene storung der orientierung am eigenen Korper","volume":"37","author":"Gerstmann","year":"1924","journal-title":"Wiener Klinische Wochenschrift"},{"key":"2022061307105548100_fcac140-B3","doi-asserted-by":"crossref","first-page":"716","DOI":"10.3171\/jns.2003.99.4.0716","article-title":"Writing, calculating, and finger recognition in the region of the angular gyrus: a cortical stimulation study of Gerstmann syndrome","volume":"99","author":"Roux","year":"2003","journal-title":"J Neurosurg"},{"key":"2022061307105548100_fcac140-B4","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/B978-0-444-63622-5.00020-6","article-title":"Gerstmann syndrome: historic and current perspectives","volume":"151","author":"Rusconi","year":"2018","journal-title":"Handb Clin Neurol"},{"key":"2022061307105548100_fcac140-B5","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1093\/brain\/awp281","article-title":"The enigma of Gerstmann\u2019s syndrome revisited: a telling tale of the vicissitudes of neuropsychology","volume":"133","author":"Rusconi","year":"2009","journal-title":"Brain"},{"key":"2022061307105548100_fcac140-B6","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1093\/brain\/89.2.183","article-title":"The enigma of Gerstmann\u2019s syndrome","volume":"89","author":"Critchley","year":"1966","journal-title":"Brain"},{"key":"2022061307105548100_fcac140-B7","volume-title":"Right-left discrimination and finger localization: Development and pathology. 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